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NUR 240 > 202 Exam 3 > Flashcards

202 Exam 3 Flashcards

1
Q

Palpable sinuses

A

frontal and maxillary

ethmoid and sphenoid are too deep to palpate

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2
Q

dry tongue can indicate

A

dehydration

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3
Q

what are the three salivary glands and know location

A

parotid (largest)
submandibular
sublingual

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4
Q

structures of the throat

A

oropharynx
tonsils
nasopharynx

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5
Q

signs and symptoms of dehydration (assess oral cavity)

A

dry mucous
fissures in tongue

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6
Q

aging adult oral cavity considerations

A

diminished small and taste
atrophic tissues
dental changes
mouth dryness
tooth loss
care of teeth/dentures

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7
Q

normal nasal mucosa color

A

red smooth moist

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8
Q

nasal mucosa: allergies

A

mucosa swollen
gray

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9
Q

nasal mucosa: rhinitis

A

swollen, bright red, drainage

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10
Q

assess for jaundice at the ___ for individuals with ____ pigmentation

A

buccal mucosa, dark

should be pink-brownish color

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11
Q

No movement of the uvula

A

can show there is no gag reflex, don’t want to feed bc high risk for aspiration

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12
Q

normal tonsils

A

oval shape, rough or granular appearance, visibility: 1+ (can visibly see tonsils) to 4+ (can’t see the uvula)

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13
Q

infected tonsils

A

bright red and swollen

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14
Q

perforated septum

A

A hole in the cartilaginous septum
Commonly caused by drug use (cocaine and methamphetamines), chronic infections, or trauma

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15
Q

abnormalities of the lip: herpes simplex I

A

cold sore that evolve into pustules, which rupture, weep and crust
lasts about 4-10 days
contagious by direct contact
recurrent infections may be brought on by sunlights fever, colds, and allergies

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16
Q

abnormalities of the buccal mucosa: leukoplakia

A

Lesions are precancerous and Chalky thick white raised patch with defined boarders
Lesion is firmly attached and does not scrape off
Lateral edges of tongue
Caused by chronic irritation of smoking and alcohol use

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17
Q

abnormalities of the buccal mucosa: candidiasis

A

White cheesy curd like patches (thrush)
It does scrape off, leaving a raw, red surface that bleeds easily
Occurs after use of antibiotics and corticosteroids and in immunosuppressed people (HIV)

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18
Q

abnormalities of the lip: carcinoma

A

An ulcer with rolled edges, indurated
Grows insidiously and may go unnoticed for months
lesions that is unhealed after 2 weeks should be referred
May have associated leukoplakia

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19
Q

Abnormalities of the oropharynx: acute tonsillitis

A

Swollen tonsils with white or yellow exudate on tonsils
Accompanied by a severe sore throat, painful swallowing, and a fever over 101

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20
Q

Abnormalities of the oropharynx: pharyngitis

A

Infection of the pharynx that causes Bright red swollen throat, white or yellow exudate on pharynx, swollen uvula
Accompanied by severe sore throat, painful swallowing, fever over 101

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21
Q

what is an expected finding in darkly pigmented people

A

bluish lips

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22
Q

Nonsynovial joints

A

United by fibrous tissue or cartilage and are immovable like the sutures in the skull or slightly moveable like the vertebrae

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23
Q

muscles are ____% of body weight

A

40-50%

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24
Q

Synovial joints

A

Freely moveable
Type of joint found where bones are separated from one another and enclosed in a joint cavity. Lined with synovial membrane that secretes synovial fluid (lubricant) which permits movement
Shoulder, hip, elbow, and knee

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25
Q

Skeletal muscles movements

A

flexion, extension
abduction and adduction
eversion and inversion
rotation
circumduction
elevation and depression
protraction and retraction
pronation and supination

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26
Q

temporomandibular joint

A

Depressed area anterior to the tragus
Permits jaw function for speaking and chewing
Allows three motions: hinge action to open and close the jaws, gliding action for protrusion and retraction, gliding for side to side movement of lower jaw

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27
Q

Osteoporosis

A

Decrease in skeletal bone mass leading to low bone mineral density (BMD) increases risk for fractures
more common in (white) women (after menopause)

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28
Q

Rheumatoid arthritis

A

Chronic inflammatory pain condition possibly started by an autoimmune response
Inflammation of synovial tissue, hyperplasia and swelling leads to fibrosis, cartilage and bone destruction
Joint involvement is symmetric and bilateral with heat, redness, swelling, and painful movement

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29
Q

Osteoarthritis (non-inflammatory)

A

Degenerative joint disease
Non inflammatory, localized, progressive disorder involving deterioration of articular cartilages
Asymmetric joint involvement commonly affects hands, knees, hips and lumbar and cervical segments of the spine

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30
Q

Uvula should rise with phonation

A
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31
Q

six cardinal gazes

A

parallel tracking in both eyes, muscle control
testing for nystagmus or misalignment in eyes

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32
Q

the aging adult eyes

A

Cataracts
Glaucoma
Dryness
Decrease in usual activities
Presbyopia
loss of central vision

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33
Q

presbyopia

A

decrease in power for eyes to accommodate (hyperopia or farsighted)

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34
Q

aging adult: loss of central vision
and risk factors

A

caused by macular degeneration- can cause blindness (peripheral vision is okay)

associated risk with HTN, diabetes, smoking, pesticides, family history, some medications

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35
Q

Osteoporosis

A

Decrease in skeletal bone mass leading to low bone mineral density
Increased risk for fractures
Occurs primarily in postmenopausal white women

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36
Q

Ankylosis

A

Stiffness or fixation of a joint

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37
Q

articular disease

A

ie. arthritis
inside the joint capsule
produces swelling and tenderness around the whole joint
decreases active and passive range of motion

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38
Q

crepitation

A

is an audible and palpable crunching or grating that accompanies movement

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39
Q

Phalen test

A

assess for carpal tunnel syndrome
ask person to hold both hands back to back while flexing the wrist at 90 degrees
after 60 secs if the test produces numbness and burning –> + for carpal tunnel

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40
Q

tests for carpal tunnel syndrome

A

phalen test and tinel sign

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41
Q

when swelling occurs in the knee, you need to distinguish whether it is caused by soft tissue swelling or increased fluid in the joint. comparison with the unaffected knee is important. which tests can you use to aid this assessment

A

Bulge sign and ballottement

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42
Q

McMurray test

A

test to check for meniscal tears
if you hear or feel a “click” = + for torn meniscus

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43
Q

lasegue test

A

confirms the presence of sciatica and a herniated nucleus pulposus

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44
Q

Ortolani maneuver

A

checks the hips for developmental dysplasia (DDH)

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45
Q

perform a _____ _____ to establish baseline and assess ADLs

A

functional assessment

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46
Q

Ankylosing Spondylitis

A

chronic inflamed vertebrae that is in extreme form leads to bony fusion of vertebral joints
affects the spine, pelvis, and thoracic cage (lower back stiffness)

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47
Q

most frequent type of joint dislocation

A

glenohumeral dislocation

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48
Q

three cranial nerves for extraocular movement: cranial nerve VI

A

The Abducens innervates the lateral rectus muscle (abducts the eye)

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49
Q

three cranial nerves for extraocular movement: cranial nerve IV

A

The Trochlear innervates the superior oblique (need it to “cross” your eyes)

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50
Q

three cranial nerves for extraocular movement: cranial nerve III

A

The Oculomotor innervates all the rest (most of the movement of our eyes)

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51
Q

Snellen eye chart tests

A

central visual acuity
higher the bottom number = the worst the vision (20/15 is better than 20/200)

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52
Q

age related macular degeneration

A

loss of central vision caused by yellow deposits (drusen) and neovascularity in the maculla
affects people over the age of 80 and women
fine tune vision is affected (peripheral vision is okay)

53
Q

risk factors for macular degeneration

A

HTN, diabetes, smoking, pesticides, family history, some medications

54
Q

preorbital edema

A

lids are swollen and puffy, accumulation of excess fluid
common in patients with CHF

55
Q

anisocoria

A

unequal pupil size
affects 5% of the population
does not change to light stimuli
indicated CNS dysfunction (head injury, increased intracranial pressure) (medications such as narcotics and opioids)

56
Q

eye accommodation test

A

assesses how pupils constrict to near objects

Looking at something far distance (pupils with relax and dilate) then put an object in front of them (pupils should constrict as they look at the close object) then bring closer (pupils converge)

CN 3 and 4

57
Q

six cardinal gazes indicates muscle weakness during movement and will tell you which cranial nerve is affected

A

III III
\ /
VI — eye — III
/ \
III IV

58
Q

pupillary light reflex direct and consensual

A

direct- look at one eye to see if it constricts with light
consensual- look at BOTH eyes to see if they constrict with light

59
Q

normal pupil resting size

A

3, 4, or 5mm

60
Q

red reflex

A

this reflex is the normal reflection from the scope light on the inner retina
cataracts will appear as opaque black

61
Q

myopia

A

nearsighted

62
Q

hyperopia

A

farsighted

63
Q

open angle Glaucoma

A

most common type of glaucoma; virtually no symptoms are exhibited.
Vision loss begins with the peripheral vision, which often goes unnoticed because individuals learn to compensate intuitively by turning their heads.

64
Q

Glaucoma vs cataracts

A

Glaucoma- condition where a buildup of pressure in the eye causes damage to the optic nerve which is the vital link of the eye to the brain which processes visual information
cataract- change in the lens of the eye; the result is cloudiness as light is prevented from entering the eye properly. (CLOUDY LENS)

65
Q

Tympanic membrane (eardrum)

A

separates the external and middle ear, should be translucent, pearly-gray, and reflect light / vibrates from sound waves

66
Q

Conductive hearing loss

A

CN VIII
dysfunction of external or middle ear (i.e. foreign bodies, perforated TM, otosclerosis)

67
Q

Sensorineural (perceptive) hearing loss

A

CN VIII
pathology of Inner Ear, CN VIII, or Auditory areas of Cerebral Cortex (i.e. presbycusis, ototoxic drugs, brain injury)

68
Q

presbycusis

A

Sensorineural hearing loss that affects the middle ear structures or causes damage to the nerve cells in the inner ear or CN VIII (gradual nerve degeneration)
affects men more than women (whites and Hispanics)

69
Q

Otosclerosis

A

conductive hearing loss in young adults between 20 and 40

70
Q

Labyrinth in the Inner Ear

A

constantly feeds imformation to your brain about your position in space
ie. vertigo

71
Q

Vertigo

A

labyrinth becomes inflamed and feeds wrong information to the brain creating staggering gait and strong spinning/whirling sensation

sensation of spinning (subjective) or room is spinning (objective)

72
Q

how to assess an infants ear vs adults ear

A

adults ear- pull pinna up and back
infants: pull pinna down

73
Q

Tinnitus

A

ringing or buzzing in ear

74
Q

swelling of mastoid process may indicate

A

ear infection

75
Q

cone of light on TM

A

left ear: 7 o’clock
right ear: 5 o’clock
points towards nose

76
Q

hearing acuity test

A

whisper test
tuning fork test: weber test and rinne test (more accurate in detecting conductive hearing loss)

77
Q

Romberg test

A

assesses the ability of the vestibular apparatus in the inner ear to help maintain standing balance
also assesses intactness of cerebellum and proprioception

78
Q

hypothalamus funciton

A

major respiratory center with basic vital functions: temperature, heart rate, blood pressure, appetite, sex drive

79
Q

spinal cord mediates

A

reflexes

80
Q

Pons and medulla

A

controls respiration

81
Q

cranial nerve I

A

sensory
olfactory
smell

82
Q

cranial nerve II

A

sensory
optic
sight

83
Q

cranial nerve III

A

mixed
oculomotor
pupillary constriction, accommodation, and eyelid opening

84
Q

cranial nerve IV

A

motor
trochlear
down and inward movement of eye

85
Q

cranial nerve V

A

mixed
trigeminal
muscles of mastication (motor)
sensation of face, scalp, cornea

86
Q

cranial nerve VI

A

motor
abducens
lateral movement of eye

87
Q

cranial nerve VII

A

mixed
facial
facial muscles, close eye, speech, close mouth (motor)
taste on anterior 2/3 of tongue (sensory)
saliva and tear secretion (parasympathetic)

88
Q

cranial nerve VIII

A

sensory
VESTIBULOCOCHLEAR
hearing and equilibrium

89
Q

cranial nerve IX

A

mixed
glossopharyngeal
pharynx (phonation and swallowing) (motor)
taste on posterior 1/3 of tongue and gag reflex (sensory)
parotid gland and carotid reflex (parasympathetic)

90
Q

cranial nerve X

A

mixed
vagus
pharynx and larynx (talking and swallowing) (motor)
general sensation from carotid body and carotid sinus (sensory)
carotid reflex (parasympathetic)

91
Q

cranial nerve XI

A

motor
spinal accessory
movement of trapezius and sternomastoid muscles

92
Q

cranial nerve XII

A

motor
Hypoglossal
movement of tongue

93
Q

aphasia

A

loss of ability to understand or express speech

94
Q

ataxia

A

difficulty with walking and balance, hand coordination

95
Q

Decerebrate rigidity

A

upper extremities- stiffly extended, adducted; internal rotation, palms pronated
lower extremities- stiffly extended, plantar flexion, hyperextended back
indicates lesion in the brainstem at midbrain or upper pons
most ominous sign (poor prognosis - brain stem injury or damage)

96
Q

Decorticate rigidity

A

upper extremities: flexion of arms, wrist, and fingers; adduction of arms
arms are tight against thorax
lower extremities: extension, internal rotation, plantar flexion
indicates hemispheric lesion of cerebral cortex (at or above the brainstem)

97
Q

dysphasia

A

difficult speech

98
Q

dysphagia

A

difficultly swallowing
risk for aspiration

99
Q

cerebellum ataxia

A

staggering wide-based gait, difficulty with turns, uncoordinated movement (+ rombergs sign)

100
Q

ataxia: parkinsons disease

A

motor system dysfunction
tremors/ rigidity/ cogwheel rigidity
facial expression: flat, staring, mask-like/expressionless
posture is stooped, elbows, knees, and hips are flexed. steps are short and shuffling

101
Q

hemiplegia

A

one sided paralysis

102
Q

tic

A

repetitive twitching (psychogenic or neurological)

103
Q

tremor

A

involuntary contraction of opposing muscle groups
may occur at rest or with voluntary movement

104
Q

important question to ask with head injury

A

did you loose consciousness and for how long?

105
Q

phases of seizures

A

Preictal phase: Aura – subjective sensation that precedes a seizure: it can be auditory, visual, or motor

Ictal phase- time this, how long did it last and what occurred during (do not leave patient, call for help)

Postictal phase- get vitals and assess the patient

106
Q

expressive (broca) aphasia

A

pt has difficultly expressing self. Understands us but Speak in broken speech

107
Q

Receptive (Wernicke) aphasia

A

sounds like they know what they are taking about, word salad

108
Q

global aphasia

A

expressive and receptive aphasia combined, most severe and most common

109
Q

aging adult: neurological

A

Atrophy with steady loss of neuron structure in brain and spinal cord
Decreased or absent Achilles reflex, pupillary miosis, irregular pupil shape, and decreased pupillary reflexes

110
Q

order of neurological exam

A

Mental Status
Cranial Nerves
Motor Nerves
Sensory
Reflexes

111
Q

mental status assessment

A

ABCT
Appearance
Behavior
Cognition
Thought processes

112
Q

how to test cranial nerve I

A

olfactory nerve
Test sense of smell in those who report loss of smell, with the person’s eye closed, occlude one nostril and present a familiar aromatic substance

113
Q

how to test for cranial nerve II

A

optic nerve
Test visual acuity and visual fields by confrontation- snellen eye chart

114
Q

how to test Cranial Nerves III, IV, and VI

A

oculomotor, trochlear, and abducens nerves
Check pupils for size, regularity, equality, direct and consensual light reaction, and accommodation
Assess extraocular movements by cardinal positions of gaze

115
Q

testing muscle strength

A

Hand Grasp w/ push-pull
Plantar flexion & Dorsi-flexion w/ resistance
move correct limbs on command

116
Q

testing cerebellar function

A

balance test: observe gait
Romberg test
rapid alternating movements (RAM): finger to finger test, finger to nose test, heel to shin test

117
Q

grading reflexes

A

4+ very brisk
3+ brisker than average
2+ average / normal
1+ diminished
0 no response

118
Q

positive babinski reflex

A

indicates a upper motor neuron lesion (stroke, brain injury, spinal cord injury)

119
Q

Neurological recheck assessment

A

Level of Conscioiusness
Motor Function
Pupillary Response
Vital Signs
Glasgow Coma Scale

120
Q

Glasgow coma scale

A

define the level of consciousness
A fully alert, normal person has a score of 15
A score of 7 or less reflects a coma

121
Q

Stroke

A

Leading cause of long term disability
3rd leading cause of death
Most common symptoms
TIA (short lived) vs stroke (progressively get worse)

122
Q

biceps reflex tests spinal nerves

A

C5 and C6

123
Q

triceps reflex tests spinal nerves

A

C7 and C8

124
Q

brachoradialis reflex tests spinal nerves

A

C5 and C6

125
Q

quadriceps reflex tests spinal nerves

A

L2–L4

126
Q

Achilles reflex tests spinal nerves

A

L5 - S2

127
Q

cerebellum

A

motor coordination, equilibrium and balance

128
Q

ototoxic drugs can cause

A

Sensorineural (perceptive) hearing loss (CN VIII)

NUR 240 (18 decks)

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